Balloon devices and methods for use

Abstract

Balloon catheters and methods are provided for selectively occluding blood flow into a right atrium of a patient's heart communicating with an inferior vena cava (IVC) and superior vena cava (SVC). In one embodiment, a catheter includes first and second balloons adjacent one another on a distal end of the catheter shaft. During use, the distal end is introduced into the right atrium and positioned such that the first balloon is located within the right atrium. The first balloon is expanded within the right atrium and the catheter shaft directed such that the expanded first balloon engages at least a portion of the IVC to prevent substantial inflow into the right atrium from the IVC. The second balloon is then expanded to limit inflow into the right atrium from the SVC, and a medical procedure is performed within the patient's body.

I claim: 
     
       1. A method for selectively occluding blood flow into a right atrium of a patient's heart communicating with an inferior vena cava (IVC) and superior vena cava (SVC), comprising:
 introducing a distal end of a catheter shaft into the patient's vasculature, the distal end carrying first and second balloons in collapsed conditions, the first and second balloons mounted on the distal end of the catheter shaft adjacent one another, the first balloon formed from compliant or semi-compliant material and having a first length, the second balloon formed from semi-compliant or non-compliant material and having a second length longer than the first length; 
 advancing the distal end into the right atrium; 
 positioning the distal end such that the first balloon is located within the right atrium; 
 expanding the first balloon within the right atrium; 
 directing the catheter shaft such that the expanded first balloon engages at least a portion of the IVC to prevent substantial inflow into the right atrium from the IVC; 
 thereafter expanding the second balloon such that the second balloon engages at least a portion of the SVC to limit inflow into the right atrium from the SVC; and 
 performing a medical procedure within the patient's body. 
 
     
     
       2. The method of  claim 1 , wherein the distal end of the catheter shaft is advanced into the right atrium from the IVC such that the second balloon at least partially enters the SVC. 
     
     
       3. The method of  claim 1 , wherein, when directing the catheter shaft such that the expanded first balloon engages at least a portion of the IVC, at least a portion of the second balloon remains within the SVC. 
     
     
       4. The method of  claim 1 , wherein the first balloon expands to a substantially spherical shape when expanded within the right atrium, and wherein the first balloon at least partially enters the IVC when the catheter shaft is withdrawn such that the first balloon is deformed from the substantially spherical shape to enhance sealing of the IVC. 
     
     
       5. The method of  claim 1 , further comprising, upon completing the medical procedure:
 deflating the first and second balloons back to the collapsed conditions; and 
 removing the catheter shaft from the patient's body. 
 
     
     
       6. The method of  claim 1 , wherein the second balloon is expanded for sufficient time to reduce cardiac output in a desired manner. 
     
     
       7. The method of  claim 1 , further comprising monitoring pressure within the patient's heart to achieve a desired pressure curve before performing the medical procedure. 
     
     
       8. The method of  claim 7 , further comprising selectively deflating and inflating the second balloon during the medical procedure to modify inflow into the right atrium from the SVC to achieve the desired pressure curve. 
     
     
       9. The method of  claim 1 , wherein the medical procedure comprises implantation of a trans-catheter aortic valve. 
     
     
       10. The method of  claim 1 , wherein the medical procedure comprises deploying a stent-graft within the patient's thoracic aorta. 
     
     
       11. The method of  claim 1 , wherein a marker is provided on the distal end of the catheter shaft between the first and second balloons, the method further comprising using external imaging to identify the marker and thereby facilitate identifying the first and second balloons. 
     
     
       12. The method of  claim 1 , wherein the first and second balloons each includes a proximal end and a distal end, and wherein the catheter shaft comprises a first marker adjacent the proximal end of the first balloon, a second marker between the distal end of the first balloon and the proximal end of the second balloon, and a third marker adjacent the distal end of the second balloon, the method further comprising using external imaging to identify the first, second, and third markers and thereby facilitate identifying the first and second balloons. 
     
     
       13. The method of  claim 12 , wherein the first marker is used to identify the proximal end of the first balloon, the second marker is used to identify the proximal end of the second balloon, and the third marker is used to identify the distal end of the second balloon. 
     
     
       14. The method of  claim 1 , further comprising, after engaging the first balloon to at least a portion of the IVC, maintaining proximal tension on the catheter shaft to maintain the seal and prevent inflow into the right atrium from the IVC. 
     
     
       15. The method of  claim 14 , further comprising removing the proximal tension after completing the medical procedure. 
     
     
       16. The method of  claim 1 , wherein the second balloon is expanded to engage the SVC to prevent inflow into the right atrium from the SVC until a desired pressure curve is achieved, whereupon the medical procedure is performed. 
     
     
       17. The method of  claim 1 , wherein the second balloon is formed from noncompliant material such that expanding the second balloon slows but does not completely stop inflow into the right atrium from the SVC, the method further comprising expanding a third balloon surrounding the second balloon and formed from compliant or semi-compliant material, the third balloon conforming to surrounding anatomy to enhance occlusion of the SVC. 
     
     
       18. The method of  claim 17 , wherein the third balloon is selectively expanded and collapsed with the second balloon expanded to controllably obstruct inflow from the SVC during the medical procedure. 
     
     
       19. The method of  claim 1 , wherein the second balloon is expanded such that it overlies, abuts, or contacts a portion of the first balloon. 
     
     
       20. The method of  claim 1 , wherein the second balloon is selectively expanded and collapsed with the first balloon expanded to controllably obstruct inflow from the SVC during the medical procedure.